Introduction

Anxiety has been defined as an emotional state accompanied by
behavioural and autonomous reactions analogous to fear, when there
is the least change in the internal or external environment. Anxiety
leads to disorganisation of self-control and to loss of adaptability.
Anxiety is not only the anticipation of danger, and it is not
fear even if one may observe behavioural sequences found in fear:
inhibition, escape and avoidance, fear aggression, and displacement
activities. Anxiety and maladjustment are pathologies. Anxiety
is a kind of a chaos of the cognitive and emotional spheres.

Clinical signs and symptoms

In this model, cat anxiety will be divided in three groups based
on the invalidation in time: paroxysmal, intermittent and permanent
anxieties. The specificities for each of these groups will be
given for the presence, the absence or the modification of several
specific parameters: defence aggression, inhibition, scanning
behaviour, displacement activities (for example lick-alopecia),
(facial, urinary and scratching) marking behaviours , etc.

threats with crouched body posture, passage to sitting to lateral or dorsal decubitus, all claws and teeth bared: no simulations of attack.

Fear Aggression

short threatening phase, no control of the bites and scratches, autonomous responses.

Displacement activities.

Alopecia, as a consequence of excessive self-licking, are the
most frequent, then bulimia and potomania.

Extensive alopecia is only a symptom of anxiety. Treatment will
be different if it is a displacement activity or a stereotypy.
The dyssymetry (predominance on the left part of the body) observed
in dogs is not found in cats.

Alopecia

Kinds of alopecia

Symptom of:

Simple localised alopecia, on a precise spot (sometimes an old scar, the spot of an old pain,...)

This is the building and maintenance of territorial fields. These
fields are in an unstable equilibrium in a constantly variable
environment. Territorialisation asks for a constant adaptation
of the different markings. A loss of adaptability signals a pathological
state (anxiety, depression or dysthymia).

2 - Clinical signs and symptoms

Anxiety

facial marking

urinary spraying

Scratching

Avoidance marking.

Paroxysmal - Fit

=

= or +

=

= or +

Intermittent

++ or --

+ or -

+* or =

+ (anal sacks)

Permanent

-

-

-

+ (perspiration)

* multiple places in the familiar surroundings

Other peculiarities of cat anxiety.

They are summarised in tables 3 and 4.

3 - Clinical signs and symptoms

Anxiety

Inhibition

Exploration

Rolling Skin Syndrome

predatory agg.*

Paroxysmal - Fit

0

=

0

= or + same h.

Intermittent

0

+ / Hypervigilance

+

+ variable hour

Permanent

+++

partial -

+ or 0

0

*on people (owners)

4 - Clinical signs and symptoms

Anxiety

Flehmen

Sleep

Paroxysmal - Fit

=

=

Intermittent

++

Insomnia*- Hyposomnia

Permanent

partial --

Insomnia*- Hypersomnia

*Insomnia with normal sleep patterns, with awakenings every 1
to 2 hours.

Classification of clinical pictures of anxieties

Different clinical pictures have been recognised and standardised
in French-speaking Europe.

Anxieties usually first diagnosed in kittens

Deprivation syndrome

or in adolescence

Separation anxiety (rare)

The cat-toy syndrome

Anxieties from a somatic affection

Algic (painful) states anxiety

Anxiety in hyperthyroidism

Substance related anxieties

Hallucinosic eidolies

Anxieties usually diagnosed in adults

Deterritorialisation anxiety

Anxiety in close surroundings

Cohabitation anxiety

Deritualisation anxiety

Anxiety syndrome (unspecified)

Several of these anxiety disorders will be described.

Cat anxiety syndrome (unspecified)

Description.

This section groups anxiety clinical cases not described elsewhere
in specific classifications.
Aetiology.
Anxiety disorders result from external factors (evolution from
a phobia, paradoxical communication, inescapable situation, ...)
or from internal factors (hormonal imbalance, painful disease,
...).
Evolution.
Paroxysmal anxieties are stable.
Intermittent anxieties evolve to hyperaggression (instrumental
conditioning from defence aggression), permanent anxiety (increase
of inhibition), dysthymia.
Permanent anxieties are stable or evolve towards chronic depression.
Diagnosis.
It is based on the appearance of the symptoms described in the
tables.
Differential diagnosis.
Cat Anxiety Syndrome (unspecified) has to be differentiated from
other specific anxiety disorders. Intermittent anxiety must be
differentiated from somatic diseases. Permanent anxiety has to
be differentiated from chronic infectious diseases. A diagnosis
of organic disease (hyperthyroidism, ...) does not exclude an
anxiety disorder.
Prognosis.
It is generally favourable. It is reserved for intermittent anxiety
because of instrumentalisation of defence aggression and the rupture
of the human-animal bond.
Treatments.
Drug treatment will be individually defined according the symptoms.
One can use the following model of brain aminergic neurotransmission
to define the drugs of choice.

Behavioural therapy.
It will be adapted to each case: habituation, desensitisation,
counterconditioning, ...

Deprivation anxiety

This syndrome is very similar to the one described in dogs. Cats
that have lived their development in poorly stimulating surroundings
may not adjust in richer environments when adult. But people find
it normal for a cat to be fearful, so they do not consult for
it.
There are two main disorders.
Intermittent deprivation anxiety in cats not socialised to people
et forced to live with them: you may find anorexia in the presence
of people, feeding at night, limited scanning fields, hypervigilance,
hyposomnia, fear aggression on people manipulating the cat, ...
Permanent deprivation anxiety in cats not imprinted to the external
environment, acquired at a very young age, with imprinting and
hyperattachement to one owner: infantilism, sucking on owner and
wovens, separation anxiety.

Deterritorialisation anxiety (DTA)

Description.
Anxiety with alteration of facial marking and production of urinary
marking. This is the main reason for consulting.
Pathogeny and symptoms.
The disruption of the territorial appeasing markings leads to
increased facial marking (appeasing), scratching and urine spraying
(excitement).
There are two stages. 1- reactive urine spraying on limited spots
from a excited or fearful cat. 2- increased urine spraying in
anxious cats. In this case, the owners have frequently punished
the cat (long) after the spraying sequence. There is also deritualisation.
Evolution.
This may lead to instrumental spraying and general soiling.
Treatment.
F3 analogous pheromones (FeliwayR) will easily treat
reactive deterritorialisation. Psychotropic drugs will be needed
for deterritorialisation anxiety.
Therapy.
Reterritorialisation may be necessary. Putting the cat in a small
room with the help of F3 pheromones for a week may help appease
him, before scanning the larger surroundings.

Anxiety in closed surroundings

Description.
Cats may not adapt easily to a life in small, closed, surfaces.
They may develop anxiety accompanied by redirected predatory aggression
on people.
Pathogeny and symptoms.
A favourable factor may be the development of the kitten in a
stimulating environment (outside, access to external environment)
before shutting him inside a hypostimulating apartment.
90% of the cats shut in closed surroundings may present fits of
hyperactivity with or without predatory aggression redirected
on people ankles or hands. Theses behavioural sequences may become
stereotyped.
Evolution.
From a reactive desire of activity due to a hypostimulating environment,
the cat may become anxious and hyperaggressive (instrumental conditioning
of aggressive sequences). There is no spontaneous cure. A first
stage may be helped by enrichment of the environment (moving decoys
to redirect hunting behaviour, frequent meals). Hyperaesthesy
may lead to lick alopecia.
Diagnosis.
Anxiety - fits of hyperactivity - rolling skin syndrome - irritation
aggression - hypervigilance, primary organic symptoms (salivation,
diarrhoea), secondary organic symptoms (alopecia), avoidance markings
(and perspiration) - hypostimulating living environment for a
cat reared up in a more stimulating environment.
Treatment.
If the enrichment of the environment is not sufficient, drugs
will be necessary.
Therapy.
Stimulating objects and decoys. Frequent meals.

Cohabitation anxiety

Description.
Cats who have to live together may present different patterns
of degradation of their emotional states and communicative skills.
Two cats (at least) are acting a drama in 3 stages, with the frequent
involuntary help of the owners.
Aetiology.
It may be the arrival of a new cat, but also the return of a cat
that has been hospitalised, anaesthetised, that is sick, old,
confused, ...
Evolution.
There is a passive and an active cat.

Aloofness: in the first stage, both cats are increasing the
distance between themselves and their own fields.

Skirmish: in the second stage, the moving (escaping) passive
cat is attacked by the active one and followed; the passive cat
activity fields are invaded by the active cat.

Differential diagnosis.
It is very important to find out if one or both cats are not suffering
from anything else than anxiety, like dysthymia, hormonal imbalance,
...
Treatment.
It will vary with each stage.

Selegiline for both cats. P. Pageat has described a therapeutic
protocol with hospitalisation of both cats in separate but contiguous
cages (with an increasing opening between the cages), with F3
pheromones, Selegiline treatment. There are positive results in
76% of the cases.

Other anxiety disorders

Several clinical pictures of anxieties may be briefly presented:
anxiety in hyperthyroidism, after the use of ketamin, in algic
states, separation anxiety, and deritualisation anxiety.

Conclusions

Anxiety is not fear, it is not phobia. It is a pathology; fear
is not. Clinical observation has lead several authors to describe
peculiar anxiety disorders and treat them effectively.